INFLAMMATORY BOWEL DISEASE SEROLOGIC MARKERS IN CHILDREN; CORRELATION WITH CLINICAL FINDINGS: A REPORT BY THE PEDIATRIC IBD COLLABORATIVE GROUP

Abstract

Introduction: Several serologic markers including ASCA, anti-OmpC, and pANCA characterize patients with Crohn disease (CD). Aim: To determine whether these markers are found more commonly in different sub-groups of pediatric CD patients and whether they correlate with clinical course. Methods: Data were obtained from the prospective observational registry of the Pediatric IBD Collaborative Research Group. Results: One hundred and forty six patients with CD had complete data available for study. 61 (42%) were ASCA positive, 23 were pANCA positive (16%) and 22 were anti-OmpC positive (15%). Four patients (2.7%) were ASCA/ANCA positive, 14 children (9.6%) were ASCA/OmpC positive, and one child (0.7%) was positive for all three. Children who were ASCA positive were more likely to be >10 years (95.1% versus 78.8%, p = 0.006) and have disease in the terminal ileum (90.2% versus 71.8% p = 0.007). Children who were ASCA negative were more likely to have left sided colonic disease (72.9% versus 27.1%, p = 0.031). Thirteen children were identified with perianal fistulae and none of them were pANCA positive. All children who were anti-OmpC positive while being ASCA negative (n = 7) had CD involving the ascending and transverse colon. 90% of ASCA-/pANCA+ patients had left-sided colon disease, while 25% ASCA+/pANCA+ had left-sided colon disease (p = 0.021). There was no difference in race, gender, disease severity at diagnosis, or response to subsequent therapy. ASCA positivity did not predict the use of infliximab therapy or surgical intervention in the first year post-diagnosis. Conclusions: ASCA positive children with CD are more likely to be >10 years old and to have disease in the terminal ileum, while those ASCA negative are more likely to have left sided colonic disease. The presence or absence of ASCA was not helpful in predicting clinical course.